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Current Diabetes Reviews

Editor-in-Chief

ISSN (Print): 1573-3998
ISSN (Online): 1875-6417

TECHNICAL NOTE

T-wave Area Dispersion in Coronary Artery Bypass Grafting is Indicative for Increased Risk of Adverse Events in Diabetics

Author(s): Dimitar Simov, Ivaylo Christov* and Iana Simova

Volume 15, Issue 5, 2019

Page: [347 - 348] Pages: 2

DOI: 10.2174/1573399815666190115150321

Price: $65

Abstract

Problems in measuring the QT-dispersion are associated mostly with the inaccurate location of the T-wave end. The complications are: (i) In methodology due to various definition for Tend, (ii) In automatic measurements, due to low amplitude of T-wave, presence of U-wave and noise, and (iii) In manual measurements, due to lack of repeatability in the results, and involuntary subjectivism, when the QT-dispersion is measured by a person familiar with the ultimate goal of the study.

New ECG repolarization parameter, ‘T-Wave Area Dispersion’ (TWAD), has been defined by Kenttä et al. 2018. Clustering ability of TWAD for prediction of risk for Sudden Cardiac Death (SCD) has been proven by the authors, working with a large database.

We have measured TWAD in peri-, and postoperative ECG recordings of patients, undergoing coronary artery bypass grafting. Analysis of perioperative TWAD has shown an increased risk of adverse events in diabetics. Postoperative TWAD parameters have deteriorated proportionally in both diabetics/ non-diabetics groups indicating increased cardiac risk within the first ten postoperative days.

The ability for diabetics/non-diabetics clustering of TWAD has been proven even in case of inaccurate location of the Tend. So far this is a reasonable advantage of TWAD vs. QT-dispersion in the study of ECG repolarization.

Keywords: T-wave dispersion, QT dispersion, CABG, diabetes, coronary artery, grafting.

[1]
Campbell RWF. QT dispersion may reflect vulnerability to ventricular fibrillation. BMJ 1996; 312: 878-9.
[2]
Rautaharju PM. QT and dispersion of ventricular repolarization (the greatest fallacy in electrocardiography in the 1990s). Circul 1999; 18: 2477-8.
[3]
Sahu P, Lim PO, Rana BS, Struthers AD. QT dispersion in medicine (electrophysiological Holy Grail or fool’s gold?). Q J Med 2000; 93: 425-31.
[4]
Christov II, Simova II. Fully automated method for QT interval measurement in ECG. Comp Card 2006; 33: 321-4.
[5]
Simova I, Christov I. Sources of variation in the QT readings: what should you be aware of? lecture notes, invited lecture at QT Prolongation and Safety Pharmacology, Paris, 13-14 March. Bioautom 2007; 6: 78-91.
[6]
Willems JL, Zywietz C, Arnaud P, van Bemmel JH, Degani R, Macfarlane PW. Measurement Programs. Recommendations for preprocessing. Comput Biomed Res 1987; 20(6): 543-62.
[7]
Kenttä TV, Sinner MF, Huikuri HV. Repolarization heterogeneity measured with T-wave area dispersion in Standard 12-lead ECG predicts sudden cardiac death in general population. Circ Arrhythm Electrophysiol 2018; 11(2): 1-11.
[8]
Simova I, Christov I, Bortolan G. A review on electrocardiographic changes in diabetic patients. Curr Diab Rev 2015; 11: 102-6.
[9]
Simov D, Christov I, Simova I, Matveev M, Petrov I. Electrocardiographic parameters indicative for increased risk of adverse events in diabetics after coronary artery bypass grafting. Comp Card 2017; 44: 1-4.

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